title: Hidden loss: a qualitative explorative study of children living with a parent with acquired brain injury.
abstract: OBJECTIVE
  The purpose of this study was to listen to and learn from children showing high levels of post-traumatic stress symptoms after parental acquired brain injury (ABI), in order to achieve an in-depth understanding of the difficulties the children face in their everyday lives and identify possible trauma-related feelings and relational losses.
  
  
  METHODS
  The study was qualitative, using a phenomenological approach.
  
  
  METHODS
  Fourteen children between 7-14 years of age were interviewed at home using a semi-structured interview guide. Siblings were also invited to participate.
  
  
  RESULTS
  All children were affected by their parents' ABI and the altered family situation. The children's expressions led the authors to identify six themes, including fear of losing the parent, distress and estrangement, chores and responsibilities, hidden loss, coping and support. The main finding indicates that the children experienced numerous losses, many of which were often suppressed or neglected by the children to protect the ill parents.
  
  
  CONCLUSIONS
  The findings indicated that the children seemed to make a special effort to hide their feelings of loss and grief in order to protect the ill parent. These findings contribute to a deeper understanding of the traumatic process of parental ABI that some children experience and emphasize the importance of family-centred interventions that include the children.
authors.affiliation: Department of Psychology, University of Copenhagen , Copenhagen , Denmark.
authors.forename: Rikke
authors.initials: R
authors.lastname: Kieffer-Kristensen
authors.forename: Karen Lise Gaardsvig
authors.initials: KL
authors.lastname: Johansen
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000209:etiology; D001930:Brain Injuries / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D005192:Family Health; D005260:Female; D006117:Grief; D006801:Humans; D008016:Life Change Events; D008297:Male; D010287:Parent-Child Relations; D036301:Qualitative Research; D012934:Social Isolation; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires